OPSEU Diablogue

Hugh Mackenzie, an economist with the Canadian Centre for Policy Alternatives, says in today’s Toronto Star that the current deficit hysteria is no excuse for the Harper government to end economic stimulus. In fact, Mackenzie argues, most of our stimulus has yet to flow from the Federal government, placing Canada well behind the response of other countries. Both the International Monetary Fund and the World Bank have pointed out that governments that pull their stimulus too early may cause another recessionary dip – sentiments Ontario Finance Minister Dwight Duncan has echoed publicly. MacKenzie takes a shot at one policy the McGuinty and Harper governments are committed to: “Corporate tax cuts don’t make sense.” he writes. “They put Canada out front in a race to the bottom in North America that we shouldn’t be in. They make no contribution to the recovery of businesses hurt by the recession – and not making any profit anyway – while delivering savings to industries that don’t need the help.” Duncan has already announced Ontario is giving away $4.5 billion in corporate tax cuts. Mackenzie says this week’s federal budget should put the emphasis on investments that will pay off for Canada’s economy in the long run, including addressing the health system challenges of an aging population.

In the wake of a successful Olympics support appears to be growing to continue funding elite athletes towards the next games. A recent Toronto Star editorial called upon the Federal government to pony up another $22 million towards maintaining “Own The Podium” despite a long list of competing priorities and an expanding deficit hysteria.

In the most recent Vector Poll, 97 per cent of Canadians also said they wanted government to spend more on health care. 57 per cent of these respondents said they would be willing to spend more even if it would raise their taxes.

In many ways, despite the problems and dangers we regularly highlight on these pages, our public Medicare system is still a success. Like our athletes, Canadians are willing to support spending that does produce results.

In its review of the last decade, the Canadian Institute for Health Information revealed that our life expectancy rose by three years between 1996 and 2006, a period in which governments began to respond to real funding needs after years of fiscal restraint.

Our wait times are beginning to come down thanks to escalating transfers of funding from the Federal government, a commitment that the Harper government is holding steadfast to.

More Ontarians are now able to find a family doctor, and more families are getting access to team-based care.

Despite expensive new technologies that mean less invasive surgeries and drug treatments that improve our quality of life, the overall costs of health care remains modest and well below many other countries.

During the last recession in 1992, our spending on health care was 10 per cent of our overall economic output. In 2008 it was 10.8 per cent. In 2009 it wasn’t escalating health costs that pushed that percentage to 11.9 per cent, but a shrinking economy.

Put another way, we are paying less than two cents more of each dollar on health care – both public and private – than we were almost 20 years ago. This is hardly a description of health care spending “out of control.” Globe and Mail columnist André Picard was correct when he pointed to the ‘mythology’ of ‘out of control’ health care spending. He pointed out that last year, when adjusted for inflation and population growth, our health care spending only expanded by 2.5 per cent.

Like our Olympics, we should regard the investments of the last six years not as a source of panic, but of pride. It is an indication that we were willing to correct the underfunding of the past and invest in new services that would improve our lives. At the time our leaders crowed they were striking a deal that would save Medicare for a generation.

Our health care is always under threat from tax-cutting politicians and privateers who want to skim off a greater share of the more than $180 billion spent across Canada on health each year. We know that there is plenty of room for improvement, including realizing efficiencies through better organization within the system and improving the numbers of skilled front-line staff. Despite the scandals, we still need an electronic health record and the benefits of new technologies. We could do a lot better on chronic care and mental health, among other areas.

We still have work to do. But we need to remember that our health care system is worth fighting for, especially when numerous short-sighted job cuts across the system threaten the progress we’ve made to date. These cuts are not part of a greater vision – they are just an attempt to deal with a deficit that never had anything to do with the performance of our health care providers.

In recent days the new Minister of Health has made a series of bizarre statements suggesting cutting front-line health care jobs is improving the quality of the system. These cuts are not being replaced in the community, as the government and the LHINs suggest. Don’t be fooled.

We still have not completed Tommy Douglas’ original vision of a comprehensive health system. Other countries have surpassed us in providing more comprehensive public drug plans, in providing coverage for dentistry, and in finding more humane ways of providing long term care, among other endeavours. Other countries have been able to provide more comprehensive health care and reduce their costs by using the economies of scale only a public system can provide.

We take pride in all our athletes – even those who failed to make the podium. We should take equal pride in our health system. In both cases, our elected officials need to take note and do the right thing.

Most Canadians would pay more taxes to fund health care according to a recent Vector poll. Conducted between January 5-18, 2010, the poll reveals 97 per cent of Canadians support more spending in health care with 57 per cent saying they would be willing to pay higher taxes to achieve that goal. Even a majority of Federal Conservative voters – 53 per cent – would be willing to pay more taxes to create better healthcare.

This willingness to spend more may be based on a perception that health care services have been in decline in recent years. Nearly half – 45 per cent – said their local hospital and/or health care facilities have gone down a little or a lot. Health care topped the list of perceived services in decline – the next highest being street and highway repairs at 43 per cent. 22 per cent said their local hospitals had improved.

The Ontario LHINs get failing grades on most activities according to the poll. At least half of the respondents said the LHINs did a not very good or poor job of controlling health care costs while maintaining quality (50%), keeping the public informed about changes to services (50%), or playing a role in reducing wait times (62%). The best results for the LHINs? 34 per cent said the LHIN was doing a good or verygood job of keeping the public fully informed about changes in medical services.

The results are based on 1,107 interviews conducted with adults across Canada.

The Ontario Hospital Association is calling for a province-wide pathology review after a Windsor hospital performed two unnecessary mastectomies. Hotel-Dieu Grace Hospital is reviewing 15,000 patient tests dating back to 2003. Tom Closson, head of the OHA, said peer review systems for pathologists are inadequate. “This isn’t a search and destroy Mission,” he said, “this is a peer review process that ensures we have consistent quality of interpretation through the province.” … The Quebec government is being advised to start charging its citizens for visits to the doctor. A finance advisory committee is making the recommendation in advance of the province’s spring budget. Quebec is also studying whether to end its system of regional health delivery, moving towards a more centralized model. … Seniors are actually utilizing Ontario emergency departments at a slower rate of increase than those in the 20-64 demographic according to the Canadian Institute for Health Information. The utilization rate of Ontario ERs by seniors increased by 1.5 per cent over the last five years, compared to 2.6 per cent for the rest of the adult population. The rate of hospital admissions from the ER for seniors also decreased from 28 to 25 per cent. An increased proportion of seniors are being discharged home or into long term care. Despite these lower utilization rates, the total number of senior visits to the ER increased by 10 per cent mostly due to an increase in that segment of the population. … “Out of Control” health care spending described as “mythology” by the Globe and Mail? You read it right. Health columnist Andre Picard says health care spending in Canada is not out of control. “After adjusting for inflation and population growth, spending increased by 2.5 per cent last year.” … And just in case you thought the sky was still falling, fourth quarter results are in – Canada’s economy grew by a staggering 5 per cent in the final quarter of last year, most of it due to the housing boom and public stimulus.

Alberta Liberal MLA Kevin Taft says the provincial government is moving more towards a “Calgary” model for privately delivered public health services. Taft says under the former Capital Health Authority, Edmonton had a highly successful publicly delivered service that was cheaper and more efficient than their Calgary counterparts. However, to relieve a backlog of surgeries, the Alberta government is spending $8 million, most of which will go to Calgary’s for-profit clinics. Edmonton’s public hospitals got a fraction of the new work. About 750 cataract surgeries were awarded to private facilities in Calgary while Edmonton’s Royal Alexandra Hospital is funded for 175 such surgeries. 180 hip and knee surgeries will be done at the for-profit Health Resource Centre in Calgary, while only 37 will be done in Edmonton’s public hospital.  Alberta Health Services says the for-profit hip and knee surgeries cost $14,000 each compared to $4,500 at the public hospital, but claim unexplained “hidden costs” are in the public model. Perhaps those “hidden costs” are bad PR for the for-profits.